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General NPI Number Information
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NPI Number | 1316664782
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Entity Type | Individual
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Provider Name | DAVID PATRICK BUNTING PHARMD
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Gender | Male
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Dates
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Enumeration Date | 10/26/2022
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Last Update Date | 10/26/2022
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Provider Practice Location Address
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Address Line | 7501 GRAND AVE
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City | GURNEE
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State | IL
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Zip | 60031-1551
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Country | US
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Telephone | 847-265-9641
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Fax |
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Provider Business Mailing Address
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Address Line | 1007 DEERFIELD RD APT 124
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City | DEERFIELD
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State | IL
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Zip | 60015-4149
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Country | US
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Telephone | 618-237-2109
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051.305195
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License Number State | IL
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